Basic Information
| Provider Information | |||||||||
| NPI: | 1639487382 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORMAL LIFE FAMILY SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 N WHITTINGTON PKWY STE 400 | ||||||||
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| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402225186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008660860 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 N CAUSEWAY BLVD STE 1C | ||||||||
| Address2: | |||||||||
| City: | MANDEVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704484664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9856744177 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2010 | ||||||||
| LastUpdateDate: | 04/01/2019 | ||||||||
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| AuthorizedOfficialLastName: | PANK | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PARALEGAL | ||||||||
| AuthorizedOfficialTelephone: | 5023942100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 315P00000X | Y | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mentally Retarded |
No ID Information.